Opinion

The digital revolution is upon us; how can e-prescribing help alleviate the click burden?

As we look forward to ending this pandemic, it may be valuable to look back to the Ontario Medical Association’s five-point plan for better health care, released in October, and specifically its fifth goal: To give patients a team of health-care providers and link them digitally.

Providing patients with a team of health-care providers who can communicate securely and effectively has never been more important, and I believe digital health tools will continue to play an integral role in achieving this.

Digital change in the Canadian health-care system has occurred slowly relative to other industries. However, due to the increased Cost of Physical Contact (CoPC) associated with COVID-19 – which encompasses the financial and convenience costs in addition to health risks such as viral exposure in waiting rooms associated with providing care in-person – the adoption and development of virtual care and digital health solutions has accelerated over the past two years. A survey by Canada Health Infoway found that as of April 2020, 60 per cent of patient-reported visits with family doctors were virtual. While this number has since dropped to 33 per cent, it is still more than double pre-pandemic data, when only 10-20 per cent of visits were virtual.

Digital change – even for the betterment of patient care – takes a lot of time, concerted effort and investments. Many Canadians would probably be surprised that the introduction of digital tools and the use of virtual technology in medical practices can add significant amounts of stress and, even before the pandemic, was linked to physician burnout. Rather than improving workflow, poorly integrated systems can take more time out of a physician’s day and add to the click burden so many of us already experience.

So how can we enable digital change without aggravating the change fatigue and underlying physician burnout highlighted by the OMA, the Canadian Medical Association, the College of Family Physicians Canada and other organizations?

Digitizing health care is not enough. We need to ensure that we are prioritizing usability and interoperability – building and implementing tools that can work with the systems that are already in use by physicians and pharmacists.

Funded by Health Canada, Canada Health Infoway’s e-prescribing tool, PrescribeIT, provides safer and more efficient medication management. It connects community-based prescribers through existing electronic medical records (EMR) to community retail pharmacies to enable the secure electronic transmission of prescriptions.

e-Prescribing enables vulnerable populations to limit their time outside – reducing their risk of infection.

In Canada, 93 per cent of family doctors are already using some sort of EMR system, yet prescription management persists as a chaotic mix of phone tag and some form of fax. Designed to work in the back end of the pharmacy management software and physician’s EMR, PrescribeIT is fully integrated to provide a streamlined clinician experience, operating similarly to how physicians already generate prescriptions in an EMR. The goal of seamless integration is crucial to implementing digital tools without increasing the burden associated with physicians, pharmacists and other clinicians having to use numerous technologies that don’t speak to each other.

e-Prescribing also allows pharmacists to electronically request prescription renewals from physicians with the click of a button, providing more time for patient care. It can be an equally significant asset when in-person visits with health-care professionals are not possible or recommended. By reducing the need for in-person visits, e-prescribing enables vulnerable populations to limit their time outside, thereby reducing their risk of infection – a benefit made all the more poignant given yet another COVID wave now among us.

As we continue to move toward returning to a semblance of normalcy, it’s important we don’t lose the progress that we’ve made in normalizing safe and effective virtual care. We should continue to implement tools like PrescribeIT and others – modern digital tools that enhance patient safety, continuity of care and communication within the patient’s circle of care. During the pandemic, a number of my patients who struggled with serious health conditions went from being on a few medications to several, often prescribed by multiple specialists. I know that PrescribeIT’s secure messaging functionality would have been a great asset for enhancing communication within the patients’ circles of care in near real time, providing a 21st century method of medication management.

If the COVID-19 pandemic has shown us anything, it’s that we must be persistent in prioritizing the digital transformation of health care in an accessible and equitable manner. As health-care thought leaders highlight the urgency of this goal, we must continue to advocate for digital health solutions like e-prescribing at all levels. This includes a broad coalition of clinicians – nurses, nurse practitioners, physicians, pharmacists, and more – clinical organizations, various levels of government, and all Canadian patients who are ready to see an optimized and decidedly more modern approach to health care.

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Author

Rashaad Bhyat

Contributor

Dr. Rashaad Bhyat serves as Clinician Leader on the Engagement team at Canada Health Infoway. He is a family physician with a passion for digital health and currently practices in an EMR-enabled family medicine clinic in the Greater Toronto Area.

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